Name = Temporal arteritis
Caption = The arteries of the face and scalp.
DiseasesDB = 12938
ICD10 = ICD10|M|31|5|m|30
ICD9 = ICD9|446.5
OMIM = 187360
eMedicineSubj = neuro
eMedicineTopic = 592
MeshID = D013700
The name comes from the most frequently involved vessel (
temporal arterywhich branches from the external carotid arteryof the neck). The alternative name ( giant cellarteritis) reflects the type of inflammatory cell that is involved (as seen on biopsy).
The disorder may coexist (in one quarter of cases) with
polymyalgia rheumatica(PMR), which is characterized by sudden onset of pain and stiffness in muscles ( pelvis, shoulder) of the body and seen in the elderly. Other diseases related with temporal arteritis are systemic lupus erythematosus, rheumatoid arthritisand severe infections.
It is more common in females than males by a ratio of 3:1. The mean age of onset is about 70 years and is rare at less than 50 years of age.
Patients present with:
headachecite journal |author=Moutray TN, Williams MA, Best JL |title=Suspected giant cell arteritis: a study of referrals for temporal artery biopsy |journal=Can. J. Ophthalmol. |volume=43 |issue=4 |pages=445–8 |year=2008 |month=August |pmid=18711459 |doi=10.1139/i08-070 |url=http://pubs.nrc-cnrc.gc.ca/cjo/cjo43/i08-070.pdf]
* tenderness and sensitivity on the
jaw claudication(pain in jaw when chewing)
tongue claudication(pain in tongue when chewing)
visual acuity(blurred vision)
visual loss(sudden blindness)
The inflammation may affect blood supply to the
eyeand blurred vision or sudden blindnessmay occur. In 76% of cases involving the eye, the ophthalmic arteryis involved causing anterior ischemic optic neuropathy. [cite web |author=Hayreh |title=Ocular Manifestations of GCA |url=http://webeye.ophth.uiowa.edu/dept/GCA/04-ocular.htm |date=April 3, 2003 |publisher University of Iowa Health Care |accessdate=2007-10-15] Loss of vision in both eyes may occur very abruptly and this disease is therefore a medical emergency.
Palpation of the head reveals sensitive and thick arteries with or without pulsation.
Erythrocyte sedimentation rateis very high in most of the patients, but may be normal in approximately 20% of cases.
The gold standard for diagnosing temporal arteritis is
biopsy, which involves removing a small part of the vessel and examining it microscopically for giant cells infiltrating the tissue. Since the blood vessels are involved in a patchy pattern, there may be unaffected areas on the vessel and the biopsy might have been taken from these parts. So, a negative result does not definitely rule out the diagnosis.
Radiological examination of the temporal artery with
ultrasoundyields a halo sign.Contrast enhanced brain MRI and CT is generally negative in this disorder.Recent studies have shown that 3T MRI using super high resolution imaging and contrast injection can non-invasively diagnose this disorder with high specificity and sensitivity.cite journal |author=Bley TA, Uhl M, Carew J, "et al" |title=Diagnostic value of high-resolution MR imaging in giant cell arteritis |journal=AJNR Am J Neuroradiol |volume=28 |issue=9 |pages=1722–7 |year=2007 |month=October |pmid=17885247 |doi=10.3174/ajnr.A0638 |url=http://www.ajnr.org/cgi/pmidlookup?view=long&pmid=17885247]
Corticosteroids, typically high-dose prednisone(40-60mg bd), must be started as soon as the diagnosis is suspected (even before the diagnosis is confirmed by biopsy) to prevent irreversible blindness secondary to ophthalmic arteryocclusion. Steroids do not prevent the diagnosis later being confirmed by biopsy, although certain changes in the histology may be observed towards the end of the first week of treatment and are more difficult to identify after a couple of months.cite journal |author=Font RL, Prabhakaran VC |title=Histological parameters helpful in recognising steroid-treated temporal arteritis: an analysis of 35 cases |journal=The British journal of ophthalmology |volume=91 |issue=2 |pages=204–9 |year=2007 |pmid=16987903 |doi=10.1136/bjo.2006.101725] The dose of prednisoneis lowered after a few days, although treatment may continue for up to two years.
* [http://webeye.ophth.uiowa.edu/dept/GCA/index.htm Giant Cell Arteritis article] at
University of Iowa
* [http://www.niams.nih.gov/hi/topics/polymyalgia/ Polymyalgia rheumatica article] from
National Institute of Arthritis and Musculoskeletal and Skin Diseases
Wikimedia Foundation. 2010.
Look at other dictionaries:
Temporal arteritis — Also called giant cell arteritis or cranial arteritis, this is a serious disease characterized by inflammation of the walls of the blood vessels (vasculitis). The vessels affected by inflammation are the arteries (hence the name… … Medical dictionary
temporal arteritis — noun inflammation of the temporal arteries; characterized by headaches and difficulty chewing and (sometimes) visual impairment • Hypernyms: ↑arteritis … Useful english dictionary
temporal arteritis — see arteritis … The new mediacal dictionary
temporal arteritis and hallucinations — Temporal arteritis is also known as giant cell arteritis (GCA). Both names are used to denote a vasculitis which affects (especially) the large and medium sized arteries of the head. The name temporal arteritis refers to the temporal artery,… … Dictionary of Hallucinations
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arteritis temporal — f. angiol. Enfermedad inflamatoria arterial que produce cefaleas intensas (en las regiones temporales, en la nuca, el mentón y la órbita), disfagia y claudicación de la mandíbula al masticar. Puede haber dolores articulares reumáticos en cinturas … Diccionario médico
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arteritis de la temporal — Eng. Temporal arteritis Ver arteritis de células gigantes … Diccionario de oftalmología
Arteritis, cranial — A serious disease characterized by inflammation of the walls of the blood vessels (vasculitis). The vessels affected are the arteries (hence the name "arteritis"). The age of affected patients is usually over 50 years of age. Cranial… … Medical dictionary